Rural Residency Planning and Development Program - Project abstract summary (list items) Applicant facility type: Rural Hospital. Program pathway: General Primary Care and High Need Specialty pathway residency. Residency medical specialty: Internal Medicine. Residency format: Rural residency program (non-RTP) — new program accreditation. Sponsoring institution: Oroville Hospital, Oroville, California; ACGME program ID 1400500028 (Internal Medicine). Rural target county: Butte County, California. Funding amount requested: $729,537 total over three years (within the $750,000 program ceiling). Program sustainability option(s): Option 3 (establishing a Medicare FTE resident cap as a new teaching hospital under 42 CFR 413.79(e)), layered with Option 6 (other public funding — California Song-Brown and CalMedForce and California Medicaid GME). Projected total number of residents: 18 (6 per postgraduate year at steady state). Expected dates: ACGME accreditation decision anticipated in fall 2026, following the initial accreditation site visit on July 23, 2026; first resident matriculation July 2027. Recent HRSA awards (last 5 years): none. Project abstract narrative Oroville Hospital, a private nonprofit acute-care hospital and the principal provider for rural Butte County, California, will establish a new, fully ACGME-accredited Internal Medicine residency to expand the rural physician workforce. Butte County is a federally designated shortage area with a heavy safety-net burden — approximately 40.5 percent of residents are enrolled in Medi-Cal — an aging population, and a documented, accelerating physician shortage, compounded by the lasting effects of the 2018 Camp Fire. There is no Internal Medicine residency in the rural target area today. Oroville Hospital (CCN 050030) is already an ACGME-accredited Sponsoring Institution, operating an accredited Neuropsychiatry residency since July 2025; the Internal Medicine program will train residents principally at the FORHP-rural Oroville Hospital site (inpatient, intensive care, emergency, and continuity-clinic care), with limited off-site subspecialty experience as needed. The program’s measurable objectives are to achieve and maintain ACGME accreditation; confirm and document clinical capacity; implement a competency-based, rural-focused curriculum with integrated behavioral health and telehealth; recruit residents with local and regional ties and an interest in rural and underserved practice; validate a layered Medicare and California state and Medicaid GME sustainability plan; and establish a plan to track and publicly report graduate outcomes for at least five years. The program begins training six residents in July 2027 and reaches a steady-state complement of 18. Expected outcomes are an accredited, sustainable rural residency and a durable pipeline of internists prepared for rural and underserved practice in Northern California. Led by Program Director Duke Ha, DO, under the hospital’s established GME governance, and developed with the California State Office of Rural Health, the project will be carried out over the September 1, 2026 – August 31, 2029 period of performance.